The only known cure for chronic hepatitis is liver [transplant](https://www.withpower.com/clinical-trials/transplant)ation, but this can only be offered to a minority of patients with a well-defined disease course, in which case only those whose liver recovers within 30 years are likely to have a cure. Hepatitis has an overall 5-year fatality rate of less than 2%. Liver transplantation as a cure for hepatitis is questionable and is only performed on patients whose disease has run too long to be treated with other measures. Hepatitis is now seen as a curable disease.
At least 15,000 cases of Hepatitis A occur in the United States each year. Most children who become infected with the disease show no or minimal symptoms, so their infections are usually diagnosed only retrospectively. Most children who contract the virus may never be aware of their infection, and only half of HCWs are tested for the virus. Further education about Hepatitis is needed to prevent further outbreaks of the disease.
A number of diseases that can cause an acute or protracted infection or inflammation of the liver may feature the symptoms of hepatitis. Most of the illnesses considered in this article are not associated with a disease that can cause hepatitis. However, one of the diseases of hepatitis is the hepatitis B virus, which was previously thought to only cause illness in Asians. For this reason, an international program to eliminate hepatitis B infected individuals was undertaken and this prevented hepatitis from emerging in the Western hemisphere. Hepatitis is a serious problem for the globe; there are at least 100 million people infected, and about 500,000 people die from this potentially treatable condition. The symptoms of hepatitis can vary greatly depending on the type of hepatitis.
[Hepatitis C virus is a common cause of chronic liver disease or cirrhosis in the U.S. and can cause significant morbidity and mortality. Although treatment is increasingly focused on noninvasive therapies, there has been little advancement in the treatment for chronic hepatitis C disease.
Liver disease is an occupational disease related to exposure to bioaccumulating toxins. The hepatitis that is associated with liver injury is not caused by bioaccumulating toxins.
Signs of hepatitis include fatigue, dark-colored urine, and pale, swollen gums. These signs may appear in either the acute or chronic phases of hepatitis, depending on the severity of the infection.
Clinical trials of antiviral therapies should only be performed if: 1) the trial may have a direct beneficial effect on patient quality of life; 2) the therapeutic intervention is well tolerated in the general population; and 3) evidence indicates that the study will have broad relevance to other patients, and not just those already at high risk for specific hepatitis. A well-designed placebo arm is important for any study investigating an agent with potential antiviral properties. Clinical trials for hepatitis should include a control group, and if no convincing evidence of benefit exists, the study should have a neutral protocol that aims to evaluate only the natural history of hepatitis. Trials should also notify participants at the early stages of treatment so that people can make informed decisions.
The pathogenesis of liver damage induced by HCV is not entirely understood, but there is evidence suggesting that virus-induced inflammation and an autoimmune response are involved in the development of the disease. Recent advances include treatment with antiviral drugs and immunomodulatory agents, which are hopeful. These new discoveries have potential for future treatment.
Pibrentasvir/glecaprevir is effective in patients with HCV-RNA ≥ 600,000 IU/mL. Pibrentasvir/glecaprevir is safe and well tolerated, with no appreciable dose modification during ongoing virologic suppression with pegIFN-free therapy.
Most patients (65% without contraindications and 81% with contraindications) were able to complete therapy with glecaprevir plus pibrentasvir/telaprevir. A minority of patients were able to complete therapy with glecaprevir alone (11% without contraindications). The most frequent reason for stopping glecaprevir plus pibrentasvir was due to viral resistance (n=30%; 4%).
Hepatitis A(HDA) virus infection peaks around age 40, whereas hepatitis B virus is generally acquired by age 25 or older. There can be a heightened risk for liver disease in children or adults who have a liver disease.
No clinical trials reporting on the use of combinations of glecaprevir and/or pibrentasvir, have been conducted. Based on anecdotal experience, both drugs were used in combination with several antiretroviral drugs in patients with HIV. There is some evidence to suggest that these drugs may be useful in the treatment of chronic hepatitis C.